Locking Compression Plate Fixation of Equine Tarsal Subluxations.
Authors: Keller Sara A, Fürst Anton E, Kircher Patrick, Ringer Simone, Kuemmerle Jan M
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Locking Compression Plate Fixation of Equine Tarsal Subluxations Tarsal subluxations in horses present a significant surgical challenge due to the complex nature of these injuries, which often involve multiple tissue damage patterns beyond simple joint luxation. Between 2011 and 2013, five equines (three horses and two ponies) underwent locking compression plate (LCP) fixation for tarsometatarsal (n=3) or proximal intertarsal (n=2) subluxations; CT imaging revealed that all cases involved complex injuries combining avulsion fragments with compression injuries on the opposite joint surface. All animals survived hospitalisation and were discharged, though two developed peroneal tertius ruptures and one experienced mild laminitis post-operatively; at long-term follow-up (>1 year), both ponies returned to intended use without lameness, whilst all three horses developed mild to moderate lameness at trot and were restricted to pleasure riding. Radiographic examination confirmed osteoarthritis development in the primarily affected joint in all five cases, with progression to adjacent small tarsal joints evident in two horses and one pony. Whilst LCP fixation provides stable fixation and facilitates healing, practitioners should counsel owners on guarded long-term prognoses—particularly for horses versus ponies—and the inevitable degenerative changes that develop even with successful surgical stabilisation.
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Practical Takeaways
- •LCP fixation can stabilize complex tarsal subluxations and allow return to function, but expect osteoarthritis development in affected joints regardless of fixation success
- •Outcomes differ between horses and ponies treated identically—ponies had better long-term soundness despite same injury severity, suggesting species or body weight factors influence prognosis
- •Plan for post-operative complications including laminitis and peroneal nerve-related issues (tertius rupture); monitor closely in the immediate post-operative period
Key Findings
- •Locking compression plate fixation achieved stable fixation and allowed adequate healing in 5 horses and ponies with tarsal subluxations
- •CT imaging revealed complex injuries including avulsion fragments and compression injuries on the opposite side of the subluxation
- •All 5 animals survived and were discharged; short-term complications included 1 case of mild laminitis and 2 cases of peroneus tertius rupture
- •At >1 year follow-up, both ponies returned to intended use without lameness, but all 3 horses developed mild to moderate lameness and osteoarthritis in affected and adjacent tarsal joints